Ignite Sign-up Form

First Name(Required)

Last Name(Required)

Preferred Name

Pronouns(Required)

They/them/theirs

She/her/hers

He/him/his

Prefer not to say

Other (for example: She/They , Ze/hir/hir, etc.)

Other

UWM Email(Required)

Year in School(Required)

First Year

Second Year

Third Year

Fourth Year

Fifth Year or Higher

Graduate Student

Expected Date of Graduation(Required)

Select your retreat date(Required)

Friday, February 27, 11:30am-4:00pm (Union 191)

I can’t make this date, keep me on the list for the next session

Do you need any accommodations to be able to fully participate in the program?

As lunch will be served, do you have any dietary restrictions we should be mindful of?

How did you hear about this leadership program (Please select all that apply)?(Required)

Student Leadership Program Newsletter

Nominated by a Faculty or Staff Member

UWM Events Calendar

Student Leadership Programs’ Website

Social Media

Word of Mouth

Print Material (fliers, banners, window clings)

Other

T-shirt Size(Required)